2014-11-13T11:09:35-06:00 2013-12-31 ERNST & YOUNG LLP 5 TIMES SQUARE NEW YORK NY 100366530 990 2013-01-01 943474115 Neighborhood Health Providers Inc % MARYBETH TITA NEIG 2128016000 100 Church Street Fl 18 Suite NEW YORK NY 100072601 MARYBETH TITA SVP/TREASURER 2014-11-12 CHRISTOPHER BOGGS P00032493 2013 2015-11-30 17:44:51Z X PATRICIA J WANG 100 CHURCH ST FL 18 New York NY 100072601 415321334 false X www.HEALTHFIRSTNY.ORG X 2009 NY OPERATION OF A PREPAID HEALTH SERVICES PLAN THAT PROVIDES HEALTH CARE BENEFITS TO BENEFICIARIES 5 3 4 0 0 0 0 921538254 384232851 2571937 672683 0 30415800 924110191 415321334 0 0 0 0 418344 105383 0 0 0 913606353 356194819 914024697 356300202 10085494 59021132 212263274 126050276 166395669 21754813 45867605 104295463 Operation of a prepaid health services plan that provides health care benefits to beneficiaries under Medicaid, Family Health Plus, and Child Health Plus. false false 297209907 344757530 MEDICAID-PROVIDE COMPREHENSIVE PREPAID HEALTH COVERAGE TO MEDICAID RECEIPIENTS. 25962264 31094302 FAMILY HEALTH PLUS-PROVIDE COMPREHENSIVE PREPAID HEALTH COVERAGE TO FHP RECEIPIENTS. 5870273 8381019 CHILD HEALTH PLUS-PROVIDE COMPREHENSIVE PREPAID HEALTH COVERAGE TO CHP RECEIPIENTS. 329042444 true false false false false false false false false false false false false false true true true true false false false false false false false false false false false true false false false false false false false true false false false false false true true true false false true 4292 0 4 true false false false false false false false false false false X 5 3 false true true false true true true true true false false true true true true true true false false false NY X MARYBETH TITA 2128016000 100 CHURCH ST FL 18 NEW YORK NY 100072601 JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 1.0 40.0 X 589373 107751 ELIZABETH R ST CLAIR SVP/ GENERAL COUNSEL 1.0 40.0 X X 649837 132297 EVELYN DEL ORBE COMMUNITY REPRESENTATIVE 1.0 0.0 X STEPHEN ROSENTHAL DIRECTOR 1.0 0.0 X ERIC SCALETTAR DIRECTOR 1.0 0.0 X ALVIN KAHN MD DIRECTOR TERM 2/13 5.0 35.0 X 0 0 BRUCE FLANZ DIR, PRESIDENT & CEO TERM 2/13 5.0 35.0 X 0 0 FRED BEEKMAN DIRECTOR TERM 2/13 5.0 35.0 X 0 0 MOUNIR DOSS DIR,EXECUTIVE VP&CFO TERM 2/13 5.0 35.0 X 0 0 VITO BUCCELLATO DIRECTOR TERM 2/13 5.0 X 0 0 STEVEN J BORY PRESIDENT & CEO TERM 2/13 25.0 15.0 X X 24242 0 MARYBETH A TITA SVP/CHIEF FINANCIAL OFFICER 1.0 40.0 X 610978 128713 PATRICIA J WANG PRESIDENT/CEO 1.0 40.0 X 1286944 317776 RONALD R ARFIN CFO TERM 2/13 25.0 15.0 X 35246 0 DANIEL P MCCARTHY EVP/COO 1.0 40.0 X 833034 167521 AUDREY BRAHAMSHA VP/COMPLIANCE OFFICER TERM2/13 25.0 15.0 X 24387 0 H KENNETH LAMPERT MC CHIEF MEDICAL OFFICER TERM2/13 25.0 15.0 X 30068 0 DEBORAH E HAMMOND VP, MEDICAL DIRECTOR 1.0 40.0 X 367802 26819 ARUN K BHATIA SVP/CIO 1.0 40.0 X 450195 101790 ANDREA C FORINO SVP, HUMAN RESOURCES TERM-9/13 1.0 40.0 X 574273 68186 YI QI WU VP, FACILITATED ENROLLMENT 1.0 40.0 X 388488 32572 PAUL E PORTSMORE JR SVP, BUS DEV AND MBR ACQUISI 1.0 40.0 X 368107 15300 113943 6119031 1098725 0 false true false ROYAL HEALTH CARE OF LONG ISLAND 100 CHURCH STREET NY NY 10007 MSO & MARKETING SEV. 20971918 BEACON HEALTH STRATEGIES 200 STATE STREET SUITE 302 BOSTON MA 02109 MENTAL HEALTH ADMIN. 5064050 HEALTH MANAGEMENT SYSTEMS 410 PARK AVENUE SOUTH NEW YORK NY 10016 CLAIMS RECOVERY 473129 DENTAQUEST 465 MEDFORD STREET BOSTON MA 021291454 DENTAL ADMIN. 461890 MED REVIEW INC 149 FIFTH AVENUE NEW YORK NY 10010 CHART REVIEWS 170334 5 0 MEDICAID MANAGED CARE 624100 344757530 344757530 FAMILY HEALTH PLUS 624100 31094302 31094302 CHILD HEALTH PLUS 624100 8381019 8381019 384232851 672683 672683 0 0 0 0 0 0 0 0 0 CANCELLATION OF DEBT 30415800 30415800 30415800 415321334 384232851 31088483 0 0 0 0 97611 97611 0 0 0 0 7772 7772 19342647 19342647 -5032 -5032 60952 60952 0 0 108966 108966 97223 97223 2238005 2238005 205970 205970 11882 11882 0 0 2210 2210 0 0 17657 17657 0 2200000 2200000 4993 4993 FEE FOR SERVICE CLAIMS 257177044 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356300202 356300202 PART X, LINE 2 THE PLAN IS A TAX EXEMPT, NOT-FOR-PROFIT ORGANIZATION UNDER THE LAWS OF NEW YORK STATE. THE PLAN QUALIFIES AS A TAX-EXEMPT, NOT-FOR-PROFIT ORGANIZTION UNDER 501(C)(3) OF THE INTERNAL REVENUE CODE. THE PLAN IS CURRENT WITH RESPECT TO ITS FEDERAL AND STATE INCOME TAX FILING REQUIREMENTS. MANAGEMENT IS NOT AWARE OF ANY ISSUES OR CIRCUMSTANCES THAT WOULD UNFAVORABLY IMPACT ITS TAX EXEMPT STATUS. MANAGEMENT HAS DETERMINED THAT IT HAS NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION. THE PLAN IS NO LONGER SUBJECT TO AUDITS BU THE APPLICABLE TAXING JURISDICTIONS FOR THE PERIOD PRIOR TO 2010. true true false false false false false false false JAY A SCHECHTMAN CHIEF MEDICAL OFFICER 414432 173865 1076 90479 17272 697124 ELIZABETH R ST CLAIR SVP/ GENERAL COUNSEL 453483 182487 13867 121101 11196 782134 9535 MARYBETH A TITA SVP/CHIEF FINANCIAL OFFICER 426559 172135 12284 111385 17328 739691 10988 PATRICIA J WANG PRESIDENT/CEO 826007 402833 58104 307077 10699 1604720 55266 DANIEL P MCCARTHY EVP/COO 548258 267631 17145 150193 17328 1000555 13703 DEBORAH E HAMMOND VP, MEDICAL DIRECTOR 285779 80142 1881 15300 11519 394621 ARUN K BHATIA SVP/CIO 341008 108202 985 86195 15595 551985 ANDREA C FORINO SVP, HUMAN RESOURCES TERM-9/13 211848 112826 249599 60634 7552 642459 YI QI WU VP, FACILITATED ENROLLMENT 275301 106245 6942 15300 17272 421060 PAUL E PORTSMORE JR SVP, BUS DEV AND MBR ACQUISI 330625 35625 1857 15300 383407 SCHEDULE J, PART 1, LINE 4A THE FOLLOWING INDIVIDUAL ENTERED INTO SEVERANCE AGREEMENTS AND/OR RECEIVED SEVERANCE PAYMENTS FROM HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION: ANDREA FORINO TOTAL OF SEVERANCE AGREEMENT IN 2013: $442,771 SEVERANCE PAID IN 2013: $85,148 SEVERANCE DEFERRED: $357,623. SCHEDULE J, PART 1, LINE 4B RETIREMENT PLAN PROVIDED BY HF MANAGEMENT SERVICES, LLC - A RELATED ORGANIZATION. THE AMOUNTS BELOW REPRESENT CONTRIBUTIONS FROM THE PLAN SPONSOR FOR 2013: PATRICIA J. WANG $81,900. [Col. C] DANIEL P. McCARTHY $36,604. [Col. C] ELIZABETH R. ST CLAIR $28,539. [Col. C] JAY A. SCHECHTMAN $20,401 [Col. C] MARYBETH A. TITA $25,943. [Col. C] ARUN K.BHATIA $19,238. [Col. C] ROYAL HEALTH CARE OF LONG ISLAND LLC COMMON OFFICERS/DIRECTORS 19342647 MANAGEMENT AND ADMIN SERVICES false FORM 990, PART VI, SECTION A, LINE 3 NEIGHBORHOOD HEALTH PROVIDERS, INC. (NHP) CONTRACTS WITH ROYAL HEALTH CARE OF LONG ISLAND, LLC (ROYAL) FOR MANAGEMENT AND ADMINISTRATIVE, MARKETING, MANAGEMENT AND SUPPORT SERVICES. ROYAL IS A MANGEMENT SERVICE ORGANIZATION THAT PROVIDES THESE SERVICES TO PREPAID HEALTH SERVICE PLANS AND OTHER HEALTHCARE PROVIDERS. NHP HAD ENTERED INTO AN AGREEMENT WITH ROYAL FOR THE PROVISION OF ADMINISTRATIVE, MARKETING, MANAGEMENT AND SUPPORT SERVICES. NHP AND ROYAL EXECUTED A 20 YEAR AGREEMENT IN 1996, WHICH WAS SUBJECT TO REGULATORY APPROVAL EVERY FIVE YEARS. THE AGREEMENT HAS BEEN APPROVED THROUGH 2013. NHP PAID FEES AS SPECIFIED IN THE AGREEMENT ON A PER MEMBER PER MONTH BASIS. ON JANUARY 31, 2013, HEALTHFIRST ACQUIRED AND BECAME THE SOLE MEMBER OF NHP. NHP ENTERED INTO A NEW MANAGEMENT AGREEMENT WITH ROYAL EFFECTIVE JUNE 1, 2013 AND EXPIRING ON MAY 31, 2015 FOR MANAGEMENT SERVICES AS PART OF NHP'S WIND DOWN PROCESS. THERE ARE 4 EMPLOYEES PAID BY NHP FOR THE YEAR OF 2013. EXCEPT THESE 4 EMPLOYEES LISTED IN PART VII, STARTING FROM JANUARY 31, 2013, ALL OFFICERS, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES WERE PAID BY, AND WORKED FOR HF MANAGEMENT SERVICES, LLC (HFMS) A MANAGEMENT COMPANY WHICH PROVIDES MANAGEMENT SERVICES FOR MUTIPLE ENTITIES. HFMS IS ALSO AN AFFILIATE OF ROYAL. NONE OF THE INDIVIDUALS LISTED EARNED ANY COMPENSATION FROM NHP SINCE JANUARY 31, 2013. ON JANUARY 31, 2013, HFMS, AN AFFILIATE OF HEALTHFIRST, INC PURCHASED 100% OF THE MEMBERSHIP INTEREST IN ROYAL. ON MAY 31, 2013, HFMS SOLD 100% OF ITS MEMBERSHIP INTEREST IN ROYAL TO INDEPENDENT LIVING SYSTEM LLC. UPON THAT SALE, ROYAL CEASED TO BE A RELATED PARTY TO NHP. ROYAL CONTINUES TO PROVIDE ADMINISTRATIVE RUN OUT SERVICES TO NHP AS AN UNAFFILIATED VENDOR. FORM 990, PART VI, SECTION A, LINE 4 SINCE JANUARY 31, 2013, THE ORGANIZATION'S GOVERNING DOCUMENTS WAS CHANGED TO FOLLOW DECISIONS AND APPROVAL OF HEALTHFIRST, INC. DUE TO ACQUISITION OF THE PLAN FROM HEALTHFIRST. PRIOR TO JANUARY 31, 2013, THE ORGANIZATION'S GOVERNING DOCUMENTS WERE UNDER SUPERVISION OF MEDISYS HEALTH NETWORK AND LINROC COMMUNITY SERVICE CORPORATION AND THEY ARE 50% EACH MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 NEIGHBORHOOD HEALTH PROVIDERS INC.(NHP) IS A NEW YORK STATE NOT-FOR-PROFIT MEMBERSHIP CORPORATION. MEDISYS HEALTH NETWORK AND LINROC COMMUNITY SERVICE CORPORATION ARE EACH 50% MEMBERS OF NHP. STARTING JANUARY 31, 2013, HEALTHFIRST INC. ACQUIRED AND BECAME THE SOLE MEMBER OF NHP. FORM 990, PART VI, SECTION A, LINE 7A FROM JANUARY 1, 2013 TO JANUARY 31, 2013, MEDISYS HEALTH NETWORK AND LINROC COMMUNITY SERVICE CORPORATION AS THE SOLE MEMBER OF NEIGHBORHOOD HEALTH PROVIDERS INC. (NHP), CAN APPOINT THE BOARD OF DIRECTORS. STARTING JANUARY 31, 2013, NHP'S SOLE CORPORATE MEMBER IS HEALTHFIRST INC. HEALTHFIRST INC. HAS THE RIGHT TO APPOINT MEMBER TO THE BOARD OF DIRECTORS OF NHP. FORM 990, PART VI, SECTION A, LINE 7B THE AMENDMENT OF THE ORGANIZATION'S GOVERNING DOCUMENTS IS SUBJECT TO THE APPROVAL OF HEALTHFIRST, INC. SOME OF THE DECISIONS OF THE GOVERNING BODY, SHOULD THEY OCCUR, ARE SUBJECT TO APPROVAL BY STATE REGULATORS: * DISTRIBUTION OF THE ORGANIZATION'S NET ASSETS * CERTAIN CHANGES TO PREMIUM RATES * EXPANSION TO OTHER MANAGED CARE BUSINESSES * SPECIFIC TYPES OF CHANGES TO THE ORGANIZATION'S BENEFIT PLANS * MANAGEMENT FEE RATE CHANGES [APPROVAL IS ALSO REQUIRED FROM THE MANAGEMENT COMPANY] FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY THE HF MANAGEMENT SERVICES, LLC (HFMS) CORPORATE FINANCE DEPARTMENT STAFF AND THEN REVIEWED BY THE HFMS VICE PRESIDENT CONTROLLER. SECONDARY REVIEWS ARE ALSO PERFORMED BY THE HFMS GENERAL COUNSEL, SENIOR VICE PRESIDENT OF CORPORATE FINANCE AND CHIEF FINANCIAL OFFICER. THE DRAFT 990 IS THEN REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. THE DRAFT 990 IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW. THE FINAL 990 IS SUBMITTED AFTER THE BOARD OF DIRECTORS REVIEWS IT. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT IS COMPLETED ANNUALLY BY EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE. EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE IS GIVEN A COPY OF THE DISCLOSURE STATEMENT TO COMPLETE ON AN ANNUAL BASIS. A MEMBER WHO DOES NOT COMPLETE THE STATEMENT IS NOT ALLOWED TO ATTEND BOARD MEETINGS AND MAY BE REMOVED FROM THE BOARD. AN OFFICER OR KEY EMPLOYEE WHO DOES NOT COMPLETE THE STATEMENT WILL BE DISCIPLINED, UP TO TERMINATION FROM THE POSITION. ANY DISCLOSURE OF A CONFLICT OR POTENTIAL CONFLICT IS REVIEWED BY THE CHIEF COMPLIANCE OFFICER. CONFLICTS ARE ADDRESSED BY EXAMINING THE RELATIONSHIP OF THE INDIVIDUAL TO THE ORGANIZATION AND THE NATURE OF THE DISCLOSURE. A REPORT OF ANY CONFLICTS IS PREPARED FOR DISCUSSION WITH AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HEALTHFIRST, INC., THE NOT FOR PROFIT CORPORATE PARENT, AS WELL AS THE FULL BOARD OF DIRECTORS OF NEIGHBORHOOD HEALTH PROVIDERS INC. AS APPROPRIATE, ACTION IS TAKEN, INCLUDING BUT NOT LIMITED TO DISCLOSURE AND RECUSAL FROM DECISION MAKING,MODIFICATIONS TO BUSINESS AGREEMENTS, CHANGES IN VENDORS OR REPLACEMENT OF THE DIRECTOR, OFFICER OR KEY EMPLOYEE WITH A NON-CONFLICTED INDIVIDUAL. FORM 990, PART VI, SECTION B, LINE 15B BECAUSE THE REPORTING ORGANIZATION DID NOT COMPENSATE ANY OFFICER OR EMPLOYEE STARTING JANUARY 31, 2013, THE REPORTING ORGANIZATION HAS RESPONDED "NO." HOWEVER, THE COMPENSATION OF THE CEO, OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY THE COMPENSATION COMMITTEE OF HF MANAGEMENT SERVICES, LLC, THE MANAGEMENT COMPANY THAT PROVIDES ALL SERVICES TO NHP.(A RELATED ORGANIZATION). THE COMMITTEE CONSISTS ONLY OF INDEPENDENT DIRECTORS. THE PROCESS FOR DETERMINING COMPENSATION IS DESCRIBED IN THE COMMITTEE'S CHARTER. THE PROCESS INCLUDES ENGAGEMENT OF AN OUTSIDE HUMAN RESOURCES CONSULTING FIRM TO CONDUCT A COMPARABILITY ANALYSIS. THE ANALYSIS INCLUDES COMPARABLE RANGES OF EXECUTIVE COMPENSATION USING THE COMPANY'S INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. INDUSTRY CLASSIFICATION. THE COMMITTEE MEETS PRIOR TO IMPLEMENTATION OF ANY CHANGE IN COMPENSATION. CONTEMPORANEOUS MINUTES OF EACH MEETING ARE PREPARED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC BY PROVIDING COPIES ON REQUEST FOR INSPECTION AT ITS CORPORATE OFFICES. FORM 990, PART XII, LINE 2C THE SELECTION OF THE INDEPENDENT AUDITOR IS ADMINISTERED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF HEALTHFIRST, INC. (A RELATED ORGANIZATION). FORM 990, PART X, LINE 24 IN 2009, THE ORGANIZATION BORROWED $25,000,000 FROM ROYAL HEALTH CARE OF LONG ISLAND, LLC (ROYAL), AN AFFILIATE OF THE ORGANIZATION THROUGH COMMON OWNERSHIP TILL JANUARY 31, 2013. THE LOAN WAS DUE ON MARCH 31, 2014 AND BORE INTEREST AT THE 1 MONTH LIBOR RATE. INTEREST ACCRUED THROUGH THE DUE DATES WAS PAYABLE ON MARCH 31, 2014. IN ACCORDANCE WITH NEW YORK STATE STATUTORY REGULATIONS, RAPYMENT OF THE PRINCIPAL AND INTEREST WAS SUBJECT TO THE APPROVAL OF THE COMMISSIONER OF THE NEW YORK STATE INSURANCE DEPARTMENT, AND COULD ONLY BE PAID ONCE THE ORGANIZATION HAS MET CERTAIN STATUTORY REQUIREMENTS. DURING DECEMBER 2010, THE ORGANIZATION BORROWED AN ADDITIONAL $5,000,000 FROM ROYAL WITH THE SAME INTEREST AND REPAYMENT TERMS AS THE ORIGINAL LOAN OF $25,000,000. THESE NOTES WERE SUBORDINATED TO THE CLAIMS OF POLICY HOLDERS, MEMBERS AND ALL OTHER GENERAL CREDITORS. ON JANUARY 28, 2013, ROYAL DISTRIBUTED THE $30 MILLION SUBORDINATED NOTES WITH ACCRUED INTEREST OF $415,800 TO ITS MEMBERS WHO IN TURN CANCELLED THE DEBT INSTRUMENT AND CONTRIBUTED THE AMOUNT DUE TO THE NET ASSETS OF THE ORGANIZATION. THIS WAS REPORTED AS OTHER REVENUE ON LINE 11 OF FORM 990. MANAGED HEALTH INC 100 CHURCH ST FL 18 NEW YORK NY 10007 113029569 MANAGED CARE NY 501 (C)4 HEALTHFIRST true HEALTHFIRST 100 CHURCH ST FL 18 NEW YORK NY 10007 133714932 MANAGED CARE NY 501 (C)3 11 Type I NA false HEALTHFIRST HEALTH PLAN OF NJ INC 1 WASHINGTON ST STE 1405 NEWARK NJ 07102 510609967 MANAGED CARE NJ 501 (C)4 HF MGMT SVCS true SENIOR HEALTH PARTNERS INC 100 CHURCH STREET 18FL NEW YORK NY 10007 134103882 MGD LT CARE NY 501 (C)3 9 HEALTHFIRST true HEALTHFIRST PHSP INC 100 CHURCH ST FL 18 NEW YORK NY 10007 133783732 MANAGED CARE NY 501 (C)3 9 HEALTHFIRST true HF MANAGEMENT SERVICES LLC 100 CHURCH ST FL 18 NEW YORK NY 100072601 134069806 3RD PTY ADM S NY NA 0 ROYAL HEALTH CARE OF LI LLC 100 CHURCH STREET New York NY 10007 3RD PTY ADM S NY HF MGMT SVCLLC false HF ADMINISTRATIVE SERVICES INC 100 CHURCH ST FL 18 NEW YORK NY 100072601 133873482 3RD PTY ADM S NY HF MGMT SVCS C CORP true false false false true false false false false false false true false false false false false false false ROYAL HEALTH CARE OF LONG ISLAND LLC L 19342647 ROYAL HEALTH CARE OF LONG ISLAND LLC L 2202761 ROYAL HEALTH CARE OF LONG ISLAND LLC E 30415800